clonazepam no longer working

[bananxiety10]

I have been on clonazepam (Klonapin) for 4 years for severe generalized anxiety. I take a relatively high dosage, 4mg at night. While it kept my anxiety in check, it left me with a hangover feeling in the morning and I was in a fog for a couple of hours after waking up. However my symtoms, insomnia, constant ear ringing, tremors etc are coming back. I can't imagine taking a higher dosage of this medicine, it will totally disable me. Does anyone else suffer from SEVERE generalized anxiety know of other meds that might help and what dosages. If I can't get this under control I am going to have to go out on disability.

thank you,

[michiganatty]

I here you about the clonazepam losing its potentcy. I too have generalized anxiety disorder, and I can not tolerate going any higher. My doctor put me on doxepin, so far it has not helped. I hope some else come into this thread with some advice.

[chrisz]

I would try splitting up the dosage. Like taking 1 mg
4 times a day. One large dose does not give you a very good
steady state level of medication.

[BurntButNotToasted]

Hi bananxiety10, I agree, Chrisz has a point. (Oh, by the way, since I'm new to the forum, a little disclaimer - I am not a Doctor, but hope my experience can help.) The half-life of clonazepam is 35 hours. K-pin has one of the longest of the benzos (the duration of effect is 12-24 hrs.), and therefore usually RX'd at 1 dose /12 hr, or sometimes 1 dose / 24hr. But one high dose, all at once is not kind to ones body chemistry, in my humble opinion. I have gone down that road, and it did not end well. It sounds like you're experiencing rebound & yo-yo effects (not fun.)
So with the half-life for K-pin - 35 hrs after taking a dose, half of the drug is still circulating in your system. In another 35 hours, half of that which was left at the first 35 hours, is circulating. And so on and so on; if you are taking your daily dosages, then you maintain a steady therapeutic dose 24/7; the optimal dosage needed to alleviate disorder symptoms.
One large dose at bedtime may cause a hangover effect because it is still working well after a typical 8 hrs of sleep, and it would be another 4 hrs before it wears off, and then consider the cumulative effects.
If sleep/ insomnia is a problem, you may consider Ambian (addictive) or some other sleep aid, and maybe Valium during the day because its primary effect lasts about 8 hrs. Or, just Valium every 8 hrs (3 dosages per day). I take 2 Valium doses/ day for GAD: 1st dose at 6am & the 2nd at 2pm. I'm lucky, sleep has not been a big problem -- I just try to exercise late afternoon to burn of anxiety & it makes me more tired at bedtime, and I use Soma for sleep on occation (for back prolems) at night.
This is a tough lesson I've experienced about some meds with a very long HL that have cumulative effects, but everone responds individually to their unique situation. And countering this line of thinking, the meds also, as you probably know, over time can become less effective due to tolerance -- more so for the anti-epileptic properties though.
Best of luck, I hope your health improves.

[michiganatty]

I here you about the clonazepam losing its potentcy. I too have generalized anxiety disorder, and I can not tolerate going any higher. My doctor put me on doxepin, so far it has not helped. I hope some else come into this thread with some advice.

UPDATE: Doxepin increased to 150mg, Tranxene as needed. Getting much better results. I must say that the antidepressants only seem to help when used with a benzo, and that they seem to counteract the cognitive impairment caused by the benzos.

Tranxene is much better than Klonopin for GAD in my opinion.

I also agree that to get the best effects from the benzos, spliting-up the total daily dosage is the way to go. My PCP though that once a day at bedtime was the way to go, but that did not work for me at all.